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Individual
MR. RUSSELL A CERTO
Active
Individual
MR. RUSSELL A CERTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT OCS
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
0100021
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000606777004
BLUE CROSS BLUE SHIELD
—
01
—
000606777005
DME
—
01
—
9352188
INDEPENDENT HEALTH
—
Enumeration date
03/16/2006
Last updated
07/13/2026
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